Obstetrical complications in pregnant medical and surgical residents.

OBJECTIVE

Pregnant residents are at risk for obstetrical complications. The purpose of our study was to evaluate the incidence and type of obstetrical complications of pregnancy during residency training, and their possible contributing factors.

METHOD

We conducted a retrospective cohort study using a web-based questionnaire sent to 190 residency programs, both medical and surgical, across North America. The questionnaire was distributed to all female residents, and participants were asked to answer the questionnaire only if they had ever been pregnant. The questionnaire consisted of 10 multiple-choice questions and focused mainly on the complications that residents may have encountered during pregnancy before and during their residency training. The results were compared with those of 3767 pregnant women of similar age.

RESULTS

The rate of obstetrical complications among residents who had up to six nights on call per month (43/163 or 26.4%) was significantly lower than those who had more than six nights on call per month (37/75 or 49.3%) (P < 0.001). Among surgical residents, 16% performed over 40 hours of surgery per week. The rate of obstetrical complications among residents who had up to eight hours of operating room time per week (8.9%) was significantly lower than among residents who worked more than eight hours per week (41.7%) (P < 0.001). When we compared obstetrical complications among residents with those of women in the general population, we found that residents had higher rates of miscarriage, hypertension in pregnancy, placental abruption, and intrauterine growth restriction.

CONCLUSION

Pregnancy during residency has a higher than average rate of adverse obstetrical outcomes. Longer operating hours and having more than six nights on call per month are associated with obstetrical complications. In addition, pregnant residents are more likely to have hypertensive disorders of pregnancy, intrauterine growth restriction, placental abruption, and miscarriages than a cohort of pregnant women of similar age.